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Cystoscopy

Rita Putatunda
Cystoscopy is a method by which a cystoscope is used to examine the bladder. Read more about it in this story.
Cystoscopy is a procedure in which the bladder is examined using a cystoscope. The cystoscope is a narrow tube akin to a telescope, with a light and a tiny camera attached to it. This procedure is carried out either as an aid for performing surgery inside the urinary tract (also known as transurethral surgery), or to check if there are any abnormalities in the bladder.

Examined Areas

  • The bladder where urine gets collected and stored
  • The urinary channel or urethra, including the prostate gland in men
  • The two small tubes, or ureters, that carry urine made in the kidneys to the bladder
A urologist, or a urologic surgeon, carries out this procedure. It involves viewing the urinary tract from within. The urologist can thus detect if there are any abnormalities, and perform the surgical procedures required.

Evaluation and diagnosis

  • Chronic pain in the pelvic region
  • Overactive bladder or urinary incontinence
  • Hematuria, or blood in the urine
  • Interstitial cystitis
  • A high frequency in urinary tract infections
  • Cancer of the bladder
  • Urinary stones or osteophytes
  • Pain during urination
  • Blockage of the urinary tract due to urinary stricture, tumors, polyps, or enlarged prostate

Abnormalities seen

  • Ureterocele, or the prolapse of the lower part of the ureter into the bladder
  • Fistula, or an abnormal passage
  • Tumors
  • Ectopic ureter, or an abnormality of its position
  • Diverticula, or sacs in the urethra
  • Trabeculation, or fibrous tissue

Procedure

Simple procedures can be carried out in the doctor's office using just local anesthesia, however, most procedures are carried out in the operating room of a hospital as an outpatient. Various types of anesthetics are used to make the process as comfortable and pain free as possible
  • The cystoscope, which is half the size of the urethra in diameter, and which can either be rigid or flexible, is inserted slowly into the urethra until it reaches the bladder.
  • The camera that is attached to the end of this device enables the physician to view the images on a screen.
  • After examining the urethra, a sterile liquid is introduced (saline or normal water) inside the bladder, which enables better viewing of the bladder wall.
  • Other instruments can be inserted through the cystoscope, allowing the physician to carry out various procedures, like the removal of a tumor in the prostate or bladder, removal of stones or osteophytes, cauterization, or stopping bleeding by applying a small charge of electricity.
  • The urologist may also use a ureteroscope in order to examine the ureters. This process, also referred to as ureteroscopy, is used for the diagnosis and treatment of urinary stones that occur higher up in the urinary tract. Usually general or regional anesthesia is used for this procedure.
  • Cystoscopy can take just a few minutes, or perhaps around 20 minutes to be performed. However, if the urologist needs to remove a tissue sample for biopsy or a stone, it can take a longer time.
  • After completion of the procedure, all the fluid that had been inserted is drained out, and a narrow, flexible tube, or catheter, is usually inserted into the bladder.

Possible Side Effects

Some of the side effects that follow this medical process include a burning sensation while urinating and hematuria. However, these are generally mild and are resolved in a few hours or days.
Patients can usually go home directly after a procedure if local anesthesia has been used. In case general or regional anesthesia has been used, the patient may require a period of recovery which can be from 1-4 hours.
Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.